RSNA: Informatics project reporting real-time radiation dose trends
CHICAGO--Creating real-time CT dose monitoring and reporting approaches can more accurately convey data in specific patient populations and enable dose data to be extracted and compared to national registries, according to a poster presented at the 96th annual meeting of the Radiological Society of North America (RSNA).

“Given the recent high-profile cases of excessive radiation exposure to patients undergoing diagnostic imaging, it is crucial that institutions begin monitoring the radiation dose from their imaging equipment,” the authors wrote.

“The amount of radiation being used to create an exam is not readily in our awareness,” Daniel L. Rubin, MD, assistant professor in the department of radiology at Stanford University in Stanford, Calif., told Health Imaging News.

“The need for real-time monitoring of dose is very important given the recent overexposure. The problem is that dose information isn’t easily accessible in electronic form,” continued Rubin. “Our goal was to develop a solution and take an approach and protocol that we believe will be generic and extendable to other vendor [CT] systems.”

Rubin and colleagues developed a protocol and adapted output patient dose information from the department’s CT scanner as DICOM SR objects (Dose SR). The researchers worked with the CT vendor to develop a protocol that enabled the dose information to be extracted out of the database from the modality and placed into a database to produce a visual summary of radiation dose.

A Java utility extracts dose values, exam procedures and patient information from the DICOM SR objects and stores them within a local database. In addition, a Linux server system receives, stores and generates reports from the dose information extracted from dose SR.

“It is as real-time as you can get. As soon as the exam is done and the DICOM SR gets pushed into our database application we update the database and can run a variety of reports,” says Rubin. “We can know whether or not an exam is meeting a specified target, what our average tracking dose is and how our average daily dose compares with national benchmarks—specifically the American College of Radiology (ACR) dose registry project.”

Older scanners do not have the capability to capture dose information, and in fact can only output this information on secondary capture images that require optical character recognition (OCR) to extract dose data, which may not be all that reliable, said Rubin.

“We need real-time feedback about whether or not we are hitting some critical thresholds of exposure that could be dangerous,” said Rubin. “This effort is all about informatics. We’ve already got the data, the information is already generated, the vendors already produce exposure values in digital form … Now we need applications that consume those numbers as those numbers are generated, as the exposure is happening and evaluates it and compares it with quality benchmarks that are being established nationally.”

Rubin said the next step in the process is expanding these data nationally to compare data and reports with the department’s databases to prevent dose overexposure.

The poster presentation is scheduled for Wednesday, Dec. 1, 2010 at 11:30 AM.